Carotid ultrasound versus heart echo to guide fluids in septic shock

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is an observational study enrolling adults with septic shock to compare carotid artery Doppler measurements (VTI and peak velocity) with echocardiographic left ventricular end-diastolic area/volume as predictors of fluid responsiveness. Investigators will obtain baseline carotid and cardiac ultrasound measures, administer a standardized fluid challenge, and repeat measurements to identify changes associated with increased cardiac output (with a ≥15% VTI change indicating responsiveness). The carotid Doppler protocol is presented as a simple, rapid bedside technique that may be easier to learn and perform in critically ill patients than full echocardiography. The work will be conducted at the Faculty of Medicine, Ain Shams University in Cairo and excludes patients with significant carotid stenosis, prior carotid surgery, or severe valvular disease.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* ▪ Age:18-50 years old

  * Sex: both males \&females.
  * Patients diagnosed with septic shock according to SOFA score more than or equal 1
  * Presence of at least one sign of acute circulatory failure from:

    1. Low blood pressure (mean arterial pressure \<65 mmHg and / or systolic \<90 mmHg).
    2. Tachycardia\> 120 bpm without other obvious cause of circulatory failure.
    3. Oliguria \<1 ml / kg during the last hour suggestive of circulatory failure.
    4. Blood hyperlactatemia \> 2mmol / l without other obvious cause a systemic circulatory failure.
    5. Another sign justifying, for example vascular increase capillary refill time more than 2 seconds.

Exclusion Criteria:

* ▪ Known significant valvular heart disease (sever aortic insufficiency or stenosis)

  * Known carotid artery stenosis \>50% or previous carotid surgery
  * Clear contraindication to the carotid artery Doppler such as wound or infection or complete or partial occlusion of the carotid artery.
  * Arrhythmias affect stroke volume assessment (atrial fibrillation, frequent PVCs)
  * Dilated cardiomyopathy.
  * Poor transthoracic echocardiographic window
  * Patient refusal

Where it's running

• Faculty of medicine, Ain Shams University
  Cairo, Egypt Recruiting

Study contacts

• Study coordinator: baheya kamel
• Email: baheya.hesham.kamel@gmail.com
• Phone: +2-01115746487

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.